Large ventricular aneurysms occurring after myocardial infarction.
Large ventricular aneurysms occurring after myocardial infarction.
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心肌梗塞后发生的大室动脉瘤。
DOI：
10.1136/hrt.40.5.516
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发表时间：
1978
影响因子：
--
通讯作者：
R. Soyer
中科院分区：
文献类型：
--
作者：
B. Letac;G. Leroux;A. Cribier;R. Soyer
我们研究了33例合并前壁心肌梗死的巨大室壁瘤患者。向动脉瘤进展的心肌梗死的特征是既往无冠状动脉疾病史，严重梗死（表现为疼痛的严重程度和心包摩擦和心力衰竭的存在），以及血清心肌酶水平大幅升高。大动脉瘤通常伴随着由左前降支完全或部分闭塞引起的大梗死，大约一半的患者仅涉及左前降支，另一半患者与回旋支和右冠状动脉病变有关。在大多数情况下，标准X线检查显示心脏构型异常，但7例患者（21%）没有动脉瘤的放射学证据。除1例受试者外，所有受试者均报告ST段抬高（平均2.7 mm）。大多数患者存在心力衰竭，三分之一的患者需要手术治疗。即使在血管造影时动脉瘤几乎占据了整个左心室，大动脉瘤也不是手术的禁忌证。21名患者接受了动脉瘤切除手术，死亡率为14%。
We have studied 33 patients with a large ventricular aneurysm complicating an anterior myocardial infarction. The features of myocardial infarction progressing towards an aneurysm were no previous history of coronary disease, severe infarction as shown by the severity of pain and the presence of pericardial rub and heart failure, and large increase in serum levels of cardiac enzymes. A large aneurysm usually follows a large infarction resulting from the total or partial occlusion of the left anterior descending artery, which is involved alone in about half the patients and is associated with lesions of the circumflex and right coronary arteries in the other half. In most cases, standard radiography showed an abnormal cardiac configuration, but in 7 patients (21%) there was no radiological evidence of aneurysm. ST segment elevation (mean 2.7 mm) was reported in all subjects but one. Heart failure was present in most patients and was an indication for surgical treatment in one-third of the patients. A large aneurysm was not a contraindication to operation even when at angiography the aneurysm seemed to occupy almost all the left ventricle. Twenty-one patients were operated upon for resection of the aneurysm with a mortality rate of 14 per cent.